| 1. |
- Karlson, BW, et al.
(författare)
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Prognosis of acute myocardial infarction in diabetic and non-diabetic patients
- 1993
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Ingår i: Diabetic Medicine. - : Wiley-Blackwell Publishing Ltd.. - 0742-3071 .- 1464-5491. ; 10:5, s. 449-454
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Tidskriftsartikel (refereegranskat)abstract
- We evaluated the prognosis of 858 patients with acute myocardial infarction (MI), of whom 97 (11%) had a history of diabetes mellitus. Among patients with diabetes the 1-year mortality rate was 41% versus 26% for non-diabetic patients (p < 0.01), and the 1-year reinfarction rates were 23% and 14%, respectively (p = 0.05). Diabetic patients with a history of hypertension had a similar mortality rate as comapred with diabetic patients without hypertension. In a multivariate analysis including age and history of cardiovascular disease, diabetes did not significantly contribute to death or reinfarction. Among diabetic patients the only independent risk factor for death was age. The place and mode of death appeared similar in the two groups. Patients with and without a history of diabetes had a similar infarct size. We conclude that diabetic patients with acute myocardial infarction have a very poor prognosis. Within 1 year nearly half of them are dead and one-quarter develop reinfarction. The mode of death appeared to be similar in diabetic patients as compared with non-diabetic patients.
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| 2. |
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| 3. |
- Agardh, Elisabet, et al.
(författare)
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A four-year follow-up study on the incidence of diabetic retinopathy in older onset diabetes mellitus
- 1994
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Ingår i: Diabetic Medicine. - 1464-5491. ; 11:3, s. 273-278
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Tidskriftsartikel (refereegranskat)abstract
- Out of 369 diabetic patients with an age at onset of diabetes > or = 30 years previously studied, 325 (88%) were included in an ophthalmological follow-up examination 4 years later. In patients treated with oral drugs at baseline, the incidence of any type of retinopathy was 30.8% and of severe retinopathy 5.7%. All patients who developed severe retinopathy received insulin during the follow-up period. At baseline, duration of diabetes, diastolic blood pressure, and signs of nephropathy (p < 0.05 in all cases) as well as degree of metabolic control (p < 0.01) differed between patients who developed retinopathy and those who did not. At follow-up, there were no longer any differences regarding degree of metabolic control and diastolic blood pressure. In patients treated with insulin at baseline, the incidence of any type of retinopathy was 41.0% and of severe retinopathy 16.1%. At baseline, duration of diabetes (p < 0.01), degree of metabolic control, and insulin dosage (p < 0.05 in both cases) differed between patients who developed retinopathy and those who did not. At follow-up, there was no longer any difference in insulin dosage.
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| 4. |
- Agardh, Elisabet, et al.
(författare)
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The five-year incidence of blindness after introducing a screening programme for early detection of treatable diabetic retinopathy
- 1993
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Ingår i: Diabetic Medicine. - 1464-5491. ; 10:6, s. 555-559
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Tidskriftsartikel (refereegranskat)abstract
- The incidence of moderate visual impairment and blindness due to diabetic retinopathy was studied 5 years after introducing a screening system for early detection of treatable retinopathy. Photocoagulation was performed in patients with clinically significant macular oedema, severe preproliferative, and proliferative retinopathy. Eighty-eight percent of 470 Type 1 and 88% of 388 Type 2 diabetic patients were still available for follow-up. In the Type 1 group, the five-year incidence of blindness and moderate visual impairment were 0.5% and 1.2%, respectively. Corresponding figures for the Type 2 diabetic patients were 0.6% and 1.7%, respectively. The majority of patients with loss of vision had severe retinopathy at baseline. Among those who entered the screening programme with no or mild retinopathy, loss of vision occurred in only one of the Type 1 and four of the Type 2 diabetic patients. It is concluded that the risk for visual impairment and blindness due to diabetes can be substantially reduced by using programmes for early detection of and effective treatment of diabetic retinopathy.
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| 5. |
- Apelqvist, Jan, et al.
(författare)
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The importance of peripheral pulses, peripheral oedema and local pain for the outcome of diabetic foot ulcers
- 1990
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Ingår i: Diabetic Medicine. - 1464-5491. ; 7:7, s. 590-594
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Tidskriftsartikel (refereegranskat)abstract
- In a prospective study, peripheral pulses, claudication, peripheral oedema, and rest pain were evaluated in 314 sequentially presenting diabetic patients with foot ulcers. In the ulcerated limb pedal pulses were found to be present in 44% of the patients, peripheral oedema in 38%, and rest pain in 19%. Twelve per cent had claudication. Presence of pedal pulses was more common in patients whose ulcers underwent primary healing (56%) than in those who healed after amputation (23%) or died (25%, p less than 0.001). Eighty per cent of the patients with pedal pulses present underwent primary healing. However, 49% of patients with absence of pedal pulses also underwent primary healing and 12 patients developed gangrene despite presence of pedal pulses. Peripheral oedema was more common in patients who required amputation (58%) or died (55%) than in patients with primary healing (26%, p less than 0.001). A tentative predisposing factor was identified in 95% of the patients, the most common factors being neuropathy, congestive heart failure, and previous deep venous thrombosis. Rest pain was more common in patients who required amputation (48%) or died (23%) than in those with primary healing (7%; p less than 0.001). Only 50% of patients with gangrene had rest pain and of these patients, only one underwent primary healing. The presence of pedal pulses, oedema, and rest pain give valuable but imperfect information on the possible primary healing of foot ulcers in diabetic patients.
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| 6. |
- Wirsen, A, et al.
(författare)
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Neuropsychological performance differs between type 1 diabetic and normal men during insulin-induced hypoglycaemia
- 1992
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Ingår i: Diabetic Medicine. - 1464-5491. ; 9:2, s. 156-165
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral function was measured with a neuropsychological test battery before, during, and after insulin-induced hypoglycaemia (blood glucose approximately 2.0 mmol l-1) in 10 male Type 1 diabetic patients (age 20-43 years, duration of diabetes 14 (2-30) years) and in 12 normal men. There were no group differences in neuropsychological results at normal glucose levels. Significant effects of hypoglycaemia were found in reaction-time measures (p less than 0.001) and in other tests requiring speed and attention (p less than 0.001), in verbal fluency (p less than 0.05), and short-term memory (p less than 0.001). Significant group effects and interactions (p less than 0.05) revealed that the diabetic patients were generally more affected by hypoglycaemia than the normal subjects. This might have been partly due to the larger absolute decrease in blood glucose level in the diabetic patients, although the rate of glucose decrease was not related to performance in either group. Thus, the diabetic brain might be more vulnerable to hypoglycaemia, perhaps through the persistent impact of repeated hypoglycaemic episodes, although no neuropsychological deficit is demonstrable at normal blood glucose levels.
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